tbuckley/cabot-search huggingface dataset:
POS0569 IDENTIFICATION OF JOINT LOCATIONS IN AN EARLY RHEUMATOID ARTHRITIS COHORT AS A CHARACTERISTIC OF DISEASE SEVERITY. DATA FROM THE ERA-UCLOUVAIN BRUSSELS COHORT
Authors: L. Bricman, S. Emilie, T. Sokolova, A. Avramovska, P. Durez
Journal: Annals of the Rheumatic Diseases (2022)

Background Early RA patients (ERA pts) often present with different areas of joint involvement, but limited data exist to identify which specific joint locations may be indicative of greater disease severity 1 . Objectives This analysis investigated the baseline (BL) prevalence of swelling in individual joint locations and their possible association with disease characteristics and prognostic factors in a cohort of ERA pts. Methods This analysis was based on data from the ERA UCLouvain Brussels cohort in which patients were included according the ACR/EULAR 2010 criteria, naïve to DMARDs and followed in our daily clinic. The physician assessed prevalence of baseline individual swollen joint status (present, absent) through a physical examination. The joint count includes 44 joints. Similarly, all patient and RA characteristics were analyzed.The association between BL swelling and disease characteristics was investigated for each individual joints. Results 453 ERA pts were analyzed, BL swelling was most frequently observed in the wrist (71.1%) followed by IPP 3 and 2 joints (52.5 and 50.1%) (Table 1). MTP4 et 5 was more present in younger and MCP 2-4 in older pt *. BL swelling in the large size joint (knee, elbow, shoulder and ankle), in the medium size joint (wrist) and the small size joint (only MCP3, IPP 1, 2 and MTP5) was highly associated with higher DAS28 (CRP) *. Pts with BL swelling MCP1, 3, 4; MTP 1,2, 5 was associated with erosive disease*. In contrast, swelling of the knee was correlated with non erosive and also seronegative RA*. Swelling of many joints locations (knee, shoulder, ankle, MCP 1-5, MTP1, 5 and IPP 1, 2) were correlated significantly with a higher HAQ*. Only swelling of MTP1, 2, 5 was associated with the presence of ACPA antibodies*. No difference was observed for smoking habits and gender. (*) - p≤0.001. Conclusion In our cohort of ERA, small joints swelling was associated with erosive and seropositive RA (only MTP). Swelling of the large joint and the wrist seems to be associated with higher disease activity. In ERA, a difference in joint location presentation may identify pts with poor pronostic factors to be eligible for an intensive treatment or a personalized treatment approach. Further analysis are planned to analyze the correlation with erosion in each joint location and response to Methotrexate. References [1]Bergstra SA, et al. RMD Open 2017 Acknowledgements This work was supported by CAP48/RTBF. Disclosure of Interests None declared.
AB0230 THE INFLUENCE OF THE PATIENT’S PSYCHOLOGICAL STATUS ON THE INFLAMMATORY ACTIVITY OF RHEUMATOID ARTHRITIS
Authors: V. Rybakova, A. Avdeeva, E. Nasonov
Journal: Annals of the Rheumatic Diseases (2022)

Objectives To examine the relationship between rheumatoid arthritis (RA) activity indicators and psychological factors of patients receiving the therapy according to the “Treat to target” (T2T) strategy. Methods The research included 93 patients with early RA (16 men and 77 women), average age Me;IQR (58 [49; 66] years), the duration of the disease 7 [4-11,5] months. All patients were prescribed a subcutaneous form of methotrexate (MT) at an initial dose of 10 mg / week with a rapid escalation of the dose to 20-30 mg / week. If the effectiveness of the therapy was insufficient, biologics were prescribed. During the first year, patients received the therapy according to the concept of T2T, then they were observed in the «real-life» clinical practice. After 6 years, the patients were re-examined. Clinical examination was performed including patient global assessment (PGA), functional status was determined by HAQ, the nature of pain by painDETECT, the presence of anxiety and depression – by HADS. Results Before the start of the therapy, the DAS 28-ESR was 5.31 [4.79; 6.14], SDAI – 28.27 [18.79; 40.73], CDAI-25 [17; 36], HAQ – 1,32 [0,75; 1,25]. After 6 years DAS28-ESR 4 [3,4; 4,59], SDAI-15,06 [9,32; 21], CDAI-15 [9; 21], HAQ - 0.5 [0.25; 1], PGE - 35 [20; 50].; activity of disease according to DAS28-ESR: remission in 7.8%, the low activity in 21.3%, the moderate activity in 60.6%, the high activity in 11.2% of patients. 29 patients had subclinically or clinically expressed anxiety (≥8 according to HADS), of whom10.3% had remission/low disease activity, 89.7% had moderate/high disease activity. 18 patients had subclinically or clinically expressed depression (≥8 according to HADS), of whom remission/low disease activity in 16.6%, the moderate/high activity was in 83.4%. In 35 patients, the painDETECT questionnaire revealed possible or probable neuropathic pain, remission/low disease activity of the was revealed in 20%, moderate/high activity in 80%. Depending on the presence of anxiety and depression, all patients were divided into two groups (Table 1). Among patients with depression, there was a greater severity of PGE pain, and more expressed functional disorders. In the group of patients with anxiety, there was a higher disease activity (according to DAS28-ESR), the severity of pain according to PGE and functional disorders; there were no significant differences between the groups in terms of ESR and CRP indicators (Table 1). Conclusion The presence of depression and anxiety negatively influences the activity of RA, leading to an increase in pain and worsening of the functional disorders. To prescribe an adequate anti-rheumatic therapy, it is necessary to take into account not only the activity of RA, but also the psychological status of the patient Disclosure of Interests None declared
POS1002 DIAGNOSTIC DELAY AND ITS ASSOCIATED FACTORS IN CHINESE AXIAL SPONDYLOARTHRITIS: A RETROSPECTIVE STUDY
Authors: X. Zheng, Z. Chen, X. Wu, X. LI, Y. Xie, J. Wu, M. Xiao, S. Cao, Q. Wei, W. Zhu, Y. Rao, Q. Chen, Y. Wen, J. Gu
Journal: Annals of the Rheumatic Diseases (2022)

Background Few data on the prolonged diagnosis and its associated factors in Chinese axial spondyloarthritis (axSpA) is available. Objectives To delineate the landscape of diagnostic delay in Chinese axSpA, investigate its associated factors and explore its potential impact on medication modalities. Methods A total of 1,295 patients fulfilling the ASAS classification criteria were obtained. Demographic and clinical data were collected through predesigned questionnaires and available medical records. Logistic regression analyses in univariate and multivariable model were performed, using the median of diagnostic delay as cut-off point for group classification. Differences between early and late diagnosed group were subsequently compared by the Pearson chi-square test or Mann-Whitney U test. Results The median (IQR) diagnostic delay in Chinese axSpA was 3.0 (1.0~7.0) years and 24.8% of them reported a history of misdiagnosis. Older age at onset (OR=0.97, P &lt;0.001) and higher education attainment ( P =0.001) were correlated with early diagnosis of axSpA, whereas coming from less developed areas ( P =0.002), a history of peripheral arthritis at the time of diagnosis (OR=1.58, P =0.002) and history of misdiagnosis (OR=1.98, P &lt;0.001) increased the risk of diagnostic delay. Medication modalities were similar between two groups, but the proportion with no medication ever and percentage without regular medication in recent 3 months were higher in the late diagnosed group than early group (26.5% vs. 20.7%, P =0.02; 34.7% vs. 28.6%, P =0.02). Conclusion Our findings depicted a detailed spectrum of diagnostic delay in Chinese axSpA, verified five associated factors and pinpointed a remarkable treatment delay even after diagnosis, especially in late diagnosis group. References [1]Masson Behar V, Dougados M, Etcheto A, Kreis S, Fabre S, Hudry C, et al. Diagnostic delay in axial spondyloarthritis: A cross-sectional study of 432 patients. Joint bone spine. 2017;84(4):467-71. Figure 1. Cumulative distribution of age at onset and age at diagnosis in Chinese axSpA (A) the entire group. (B) stratified by early and late diagnosed group. (C) stratified by education level (college, middle school, secondary school). (D) stratified by history of peripheral arthritis when diagnosed. (E) stratified by history of misdiagnoses when diagnosed. (F) stratified by native place, as statistical significance was found between eastern coastal and western China, only these two groups were presented. Disclosure of Interests None declared
AB0962 Psoriatic arthritis with positive ACPA, which features?
Authors: S. Ghazzali, I. EL Harch, N. Akasbi, I. El Mezouar, T. Harzy
Journal: Annals of the Rheumatic Diseases (2022)

Background Anti-cyclic citrullinated peptide antibodies (ACPA) have been detected in several patients with psoriatic arthritis (PsA). It is possible that these autoantibodies are associated with particular features of PsA. Objectives The objective of our study was to assess the frequency of anti-CCP antibody positivity in psoriatic arthritis, and to identify the factors associated with this positivity in PsA. Methods Observational cross-sectional study, carried out in the rheumatology department of the CHU Hassan II of FES between January 2012 and October 2021. Including 67 patients with RP fulfilling the CASPAR criteria. ACPA positivity threshold was &gt;20Ui/ml. Results Our study included 67 patients, the mean age was 55.3 +/- 15 years, the sex ratio was 0.36 M/F, the mean disease duration was 6.61 +/- 9 years. ACPA were positive in 16.4% of cases (11 patients), and negative in 83.6% of cases (56 patients). In bivariate analysis, PsA with positive ACPA was more common in men (27.8% versus 12% p=0.049), PsA patients with positive ACPA presented less inflammatory back pain (14% versus 86%) (p=0.049), developed more frequently pulmonary complications (60%) (P=0.001, and presented more often a positive rheumatoid factor (32% versus 7%) (P=0.019). In multivariate analysis, male gender was significantly related to ACPA positivity (p=0.049, OR=22.702, IC=1.05-505). Likewise for lung involvement (p=0.010, OR=67.903, IC=2.6 -1709.8). Also, ACPA positivity during PsA was significantly related to that of rheumatoid factor (RF) (p=0.05 OR=61.375 IC=0.994-3789). In addition, no statistically significant difference was found between the two groups concerning the activity of the disease, the structural impact, the biological inflammatory syndrome and the use of biotherapy. Conclusion In our study, PsA is characterized by a low predominance of a positive ACPA form. This form with positive ACPA is found in our context to be more frequent among men, more often associated with positive RF, and is more complicated by pulmonary damage. References [1]C Popescu,*,**S Zofotă,*V Bojincă,*,**andR Ionescu*,** Anti-cyclic citrullinated peptide antibodies in psoriatic arthritis –cross-sectional study and literature review Disclosure of Interests None declared
POS0981 RELATIONSHIP BETWEEN CLINICAL MANIFESTATIONS OF AXIAL SPONDYLOARTHRITIS AND PROGRESSION OF COXITIS.
Authors: E. Agafonova, S. Erdes
Journal: Annals of the Rheumatic Diseases (2022)

Background Almost half of the patients with axial spondyloarthritis (axSpA) in Russia diagnosed hip joint lesions (HJ), but the causes and rates of progression are not studied. Until now, it remains unclear whether synovitis detected on MRI and ultrasound of hip joint is a predictor of radiological progression of coxitis. Objectives To determine the factors influencing the progression of coxitis in axSpA. Methods 77 patients (mean age 28 ± 5.92 years) with a diagnosed with axSpA (ASAS criteria 2009), which were observed for at least 2 years. Among them, AS according to the modified New York criteria (1984) - 66 (86%) patients, and 11 (14%) were diagnosed with nr-axSpA. The median duration of the disease was 30 [3–60] months, BASDAI 4.5 [3.2; 5.9], BASFI 2.4 [0.9; 4.8]. All patients underwent clinical, X-ray, ultrasound and MRI examination of the hip joint during the entire observation period. For ultrasound, coxitis was considered an increase in the cervical-capsular distance (CCD) of more than 7 mm. For MRI inflammatory changes were taken as osteitis of the acetabulum and / or femoral head and synovitis in STIR mode. The sum of stages of radiographic coxitis (ssrC) was used to assess HJ injury progression. During the study, a formula was developed to assess the progression rate of radiographic coxitis (R-rpC). Results Cluster analysis of the main parameters was performed to detect the relationship between the clinical manifestations of axSpA and radiological progression of coxitis (Figure 1). During the analysis, it was found that the most closely related group of clinical parameters, such as the presence of the HLA B 27 gene and the sex of patients, the rate of radiographic progression of coxitis and srsc (Euclidean distance &lt; 20). The second group of related measures included the BASDAI and ASDAS-CRP disease activity indices, as well as their associated functional impairment (BASFI index) (Euclidean distance &lt; 30). These two groups of signs are also related to each other — Euclidean distance &lt; 30. It should be noted that laboratory indicators of inflammation (ESR and CRP), the age of patients, and especially the duration of the disease, turned out to be weakly related to each other (Euclidean distance &gt; 100). It should also be noted that the relationship between laboratory indicators of inflammation and disease activity indices is relatively weak, as well as with structural damage in axSpA. Figure 1. Conclusion Factors influencing the development and progression of coxitis in axSpA are a combination of such features as high clinical activity of the disease, the presence of peripheral arthritis, HLA B27 positivity and male sex. Disclosure of Interests None declared
AB0287 INFLUENCE OF COPING ON RHEUMATOID ARTHRITIS RELATED PAIN
Authors: O. Saidane, M. Haddad, A. Ben Tekaya, R. Leila, S. Bouden, R. Tekaya, I. Mahmoud, L. Abdelmoula
Journal: Annals of the Rheumatic Diseases (2022)

Background Most patients with rheumatoid arthritis (RA) have chronic pain. Nowadays dealing with pain is no more focused on traditional treatment only. Objectives Our study aimed to assess the impact of coping strategies on the chronic pain in RA subjects. Methods We performed a 6-month study including patients followed for RA according to ACR / EULAR 2010 criteria. The visual analogue scale (VAS) was used to assess the perception of pain. Coping was assessed by the Brief COPE questionnaire according to which five grouped strategies were identified: Problem solving that includes active coping and planning. Cognitive restructuring that combines humour, acceptance and positive reinterpretation. Support seeking that combines the search for instrumental support, the search for emotional support and religion. Avoidance that includes denial, blame, substance use and behavioural disengagement. Distraction that includes distraction and expression of feelings. Results We included 65 RA patients with 58 women and 7 men, the sex ratio was 0, 12 H/F. Mean age of the patients was 58, 6 [24 – 73 years]. Disease duration was superior to 10 years in 66, 2% of patients. RA was immunopositive in 87, 7% of cases and erosive in 83, 1 % of cases. The DAS28 (ESR) was on average 3, 4(IQR 25-75: 2, 8- 4, 6). The average of VAS was 5 ± 2,2. The perception of pain was positively associated with coping strategies based on problem solving, negatively associated to cognitive restructuring and distraction (Table 1). Table 1. Impact of coping strategies on chronic pain RA subjects B p Problem solving 0,411 0,001 Cognitive restructuring -0,371 0,002 Support seeking -0,095 0,452 Avoidance 0,243 0,252 Distraction -0,292 0,018 Conclusion Our study revealed that having coping strategies based on problem solving increased the perception of pain whereas strategies based on distraction and cognitive restructuring decreased it. Disclosure of Interests None declared
Brain metastases: A Society for Neuro-Oncology (SNO) consensus review on current management and future directions
Authors: Ayal A Aizer, Nayan Lamba, Manmeet S Ahluwalia, Kenneth Aldape, Adrienne Boire, Priscilla K Brastianos, Paul D Brown, D Ross Camidge, Veronica L Chiang, Michael A Davies, Leland S Hu, Raymond Y Huang, Timothy Kaufmann, Priya Kumthekar, Keng Lam, Eudocia Q Lee, Nancy U Lin, Minesh Mehta, Michael Parsons, David A Reardon, Jason Sheehan, Riccardo Soffietti, Hussein Tawbi, Michael Weller, Patrick Y Wen
Journal: Neuro-Oncology (2022)

Brain metastases occur commonly in patients with advanced solid malignancies. Yet, less is known about brain metastases than cancer-related entities of similar incidence. Advances in oncologic care have heightened the importance of intracranial management. Here, in this consensus review supported by the Society for Neuro-Oncology (SNO), we review the landscape of brain metastases with particular attention to management approaches and ongoing efforts with potential to shape future paradigms of care. Each coauthor carried an area of expertise within the field of brain metastases and initially composed, edited, or reviewed their specific subsection of interest. After each subsection was accordingly written, multiple drafts of the manuscript were circulated to the entire list of authors for group discussion and feedback. The hope is that the these consensus guidelines will accelerate progress in the understanding and management of patients with brain metastases, and highlight key areas in need of further exploration that will lead to dedicated trials and other research investigations designed to advance the field.
Alcohol consumption and smoking in relation to psoriasis: a Mendelian randomization study
Authors: Jiahe Wei, Jiahao Zhu, Huiqing Xu, Dan Zhou, James T. Elder, Lam C. Tsoi, Matthew T. Patrick, Yingjun Li
Journal: British Journal of Dermatology (2022)

Alcohol consumption and smoking have been reported to be associated with psoriasis risk. However, a conclusion with high-quality evidence of causality could not be easily drawn from regular observational studies.This study aims to assess the causal associations of alcohol consumption and smoking with psoriasis.Genome-wide association study (GWAS) summary-level data for alcohol consumption (N = 941 280), smoking initiation (N = 1 232 091), cigarettes per day (N = 337 334) and smoking cessation (N = 547 219) was obtained from the GSCAN consortium (Sequencing Consortium of Alcohol and Nicotine use). The GWAS results for lifetime smoking (N = 462 690) were obtained from the UK Biobank samples. Summary statistics for psoriasis were obtained from a recent GWAS meta-analysis of eight cohorts comprising 19 032 cases and 286 769 controls and the FinnGen consortium, comprising 4510 cases and 212 242 controls. Linkage disequilibrium score regression was applied to compute the genetic correlation. Bidirectional Mendelian randomization (MR) analyses were conducted to determine casual direction using independent genetic variants that reached genome-wide significance (P < 5 × 10-8 ).There were genetic correlations between smoking and psoriasis. MR revealed a causal effect of smoking initiation [odds ratio (OR) 1·46, 95% confidence interval (CI) 1·32-1·60, P = 6·24E-14], cigarettes per day (OR 1·38, 95% CI 1·13-1·67, P = 0·001) and lifetime smoking (OR 1·96, 95% CI 1·41-2·73, P = 7·32E-05) on psoriasis. Additionally, a suggestive causal effect of smoking cessation on psoriasis was observed (OR 1·39, 95% CI 1·07-1·79, P = 0·012). We found no causal relationship between alcohol consumption and psoriasis (P = 0·379). The reverse associations were not statistically significant.Our findings provide causal evidence for the effects of smoking on psoriasis risk. What is already known about this topic? Alcohol consumption and smoking have been reported to be associated with psoriasis risk. Whether alcohol consumption and smoking have a causal effect on psoriasis risk remains unclear. What does this study add? This Mendelian randomization study shows a causal association between smoking, but not alcohol consumption, and the risk of developing psoriasis. Restricting smoking could be helpful in reducing the burden of psoriasis.
AB1580-PARE REMISSION: IS IT UNKNOWN?
Authors: S. Tonolo, A. Verducci, F. Padovani, P. Grossi, G. Mussi, S. Severoni
Journal: Annals of the Rheumatic Diseases (2022)

Background Remission is the alleviation or disappearance of the symptoms of a pathology. It may be due to the cessation of a pathogenic action, its overcoming by the body’s defense mechanisms, the implementation of adequate therapy. The term is used when the phenomenon is transitory and can have variable duration, even very long (months or years). However, the morbid process persists in the body and then fatally returns to recur. But how much do patients with chronic rheumatological diseases know? How many of them know this word and, among those who know it, how many correctly understand its full meaning? Here is the objective of the campaign: to verify the level of awareness among rheumatological patients with respect to the concept of remission of the pathology. Objectives The objective of the Association, in collaboration with SIR (which has already granted the patronage to the campaign) is to verify, in 3 years, how and how much awareness has improved on the concept of remission between patients and if, and how much, doctor-patient communication will be improved on the subject. Methods This awareness campaign is on the concept of remission will start, implemented with different tools: 1 – Informative booklet on the concept of remission, on what it is and how it can be achieved. And to maintain, both from the point of view of the rheumatologist and from the patient’s point of view. The booklet will be accompanied by the results of the questionnaire mentioned above. 2- Ideation, creation and realization of a Facebook page: https://www.facebook.com/ObiettivoRemissione/ which will be used as a vehicle for a series of informative contents on the concept of remission and for an emotional video intended for the target of patients and their family: Results Started in 2020, the campaign is still ongoing and the first preliminary results will be delivered in the last quarter of 2022 Conclusion A survey conducted on 1,300 respondents, of which 93% were patients or family members of patients, shows that 26% do not know the concept of remission and only half report having heard about it from their referring physician. From an SEO survey conducted on the main search engines, then, it is clear that the concept of remission in the context of rheumatic diseases is totally absent from the Internet which is, unfortunately or fortunately, at this moment, the first research outpost by of patients or potential patients on health issues. Disclosure of Interests None declared